There has been a resurgence in the United States in the use of all forms of smokeless tobacco, including chewing tobacco and snuff. The use of smokeless tobacco of any type in general parlance is loosely referred to as "chewing," although the term "dipping" is particularly associated with the use of snuff. The use of smokeless tobacco entails the placing of a golf ball size wad of leaf tobacco or a pinch of powdered tobacco in the gingival buccal area of the mouth cavity and sucking on the quid. The term "quid" is given to a portion of smokeless tobacco which is held in the mouth for chewing or dipping. Many persons chew or dip during most waking hours, and some persons keep a quid in place for 24 hours a day.
Sales of smokeless tobacco have increased about 11% each year since 1974 with an estimated 22 million users in this country. An influx of youthful chewers and dippers, primarily young male athletes and students in high school and college, has helped sustain the increase in sales of smokeless tobacco products each year since 1974. Surveys have shown that it is not uncommon for a young boy to start habitual chewing, dipping, or both at the age of 10 to 12 in imitation of his elders and peers.
The use of smokeless tobacco has gained social acceptance. A worn, bleached round ring outline, of the size and shape of a snuff container, on the back pockets of jeans is considered a symbol of virility, maturity, and toughness.
The use of smokeless tobacco induces an increased flow of saliva; therefore, smokeless tobacco users must periodically spit out the excess tobacco juices which build up in their mouths. The spitting of the brown juices produced by smokeless tobacco is considered by users to be a source of enjoyment as well. In fact, spitting is actually an art form.
Unfortunately, it has been reported that the use of smokeless tobacco is addictive and that oral leukoplakia is a common result of the use of tobacco in the oral cavity. Leukoplakia is a lesion of the soft tissues of the mouth, the lesion having the appearance of a white patch or plaque. Leukoplakia is currently considered precancerous and has a malignant transformation rate of between 3% and 5%. Moreover, cancer of the esophagus, larynx, pharynx, and oral cavity are related to the use of smokeless tobacco products.
Studies have indicated that nausea, dizziness, hiccoughs, and throat and mouth irritation are also possible side effects of oral smokeless tobacco use. It has also been reported that smokeless tobacco can produce significant effects on the soft and hard tissues of the mouth including bad breath, discolored teeth and restorations, abrasions of the incisal and occlusal surfaces of the teeth, decreased ability to taste and smell, gingival recession, advanced periodontal destruction of the soft and hard tissues, and erythema of the soft tissues. See Journal of the American Dental Association, Vol. 101, September 1980, pp. 464-469, "The case against smokeless tobacco: five facts for the health professional to consider" by A. G. Christen and Journal of the American Medical Association. Vol. 247, No. 7, 1982, p. 947, "Snuff gives heart rate, blood pressure a kick" by P. Gunby.